Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review
Background. Ischemia/reperfusion injury after lung transplantation is a significant cause of morbidity. In the realm of ex vivo lung perfusion (EVLP), inflammation, edema formation, and reduced compliance have limited the durability of EVLP. Previous evidence has suggested that platelet activation a...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-09-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001855 |
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| author | Ryaan EL-Andari, MD Jimmy J.H. Kang, MD Nicholas M. Fialka, MD Jason Weatherald, MD Parnian Alavi, MSc Nadia Jahroudi, PhD Darren H. Freed, MD, PhD Jayan Nagendran, MD, PhD |
| author_facet | Ryaan EL-Andari, MD Jimmy J.H. Kang, MD Nicholas M. Fialka, MD Jason Weatherald, MD Parnian Alavi, MSc Nadia Jahroudi, PhD Darren H. Freed, MD, PhD Jayan Nagendran, MD, PhD |
| author_sort | Ryaan EL-Andari, MD |
| collection | DOAJ |
| description | Background. Ischemia/reperfusion injury after lung transplantation is a significant cause of morbidity. In the realm of ex vivo lung perfusion (EVLP), inflammation, edema formation, and reduced compliance have limited the durability of EVLP. Previous evidence has suggested that platelet activation and thrombosis may play a role in both conditions.
Methods. A literature search of PubMed and Embase was conducted, including all articles describing all human or animal investigations of platelet activation or the use of antiplatelet agents in the settings of EVLP or lung transplantation. Articles published from database inception to July 15, 2024, were analyzed.
Results. In total, 9 studies were included in the review. Studies on EVLP have found an association between platelet activation and adverse effects on lung function, whereas in lung transplantation, platelet activation appears to play a role in primary graft dysfunction. In both settings, the inhibition of platelets ameliorated these effects.
Conclusions. Platelet activation in EVLP and lung transplantation results in distal arterial thrombosis and has been associated with graft dysfunction. The use of antiplatelet agents in the included studies was associated with reduced lung injury and improved lung function on EVLP or during lung transplantation. |
| format | Article |
| id | doaj-art-21b7795cc774496bbdb03bbf3ddb066d |
| institution | Kabale University |
| issn | 2373-8731 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj-art-21b7795cc774496bbdb03bbf3ddb066d2025-08-26T03:26:16ZengWolters KluwerTransplantation Direct2373-87312025-09-01119e185510.1097/TXD.0000000000001855202509000-00011Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative ReviewRyaan EL-Andari, MD0Jimmy J.H. Kang, MD1Nicholas M. Fialka, MD2Jason Weatherald, MD3Parnian Alavi, MSc4Nadia Jahroudi, PhD5Darren H. Freed, MD, PhD6Jayan Nagendran, MD, PhD71 Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.1 Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.1 Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.2 Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.3 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.3 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.1 Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.1 Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.Background. Ischemia/reperfusion injury after lung transplantation is a significant cause of morbidity. In the realm of ex vivo lung perfusion (EVLP), inflammation, edema formation, and reduced compliance have limited the durability of EVLP. Previous evidence has suggested that platelet activation and thrombosis may play a role in both conditions. Methods. A literature search of PubMed and Embase was conducted, including all articles describing all human or animal investigations of platelet activation or the use of antiplatelet agents in the settings of EVLP or lung transplantation. Articles published from database inception to July 15, 2024, were analyzed. Results. In total, 9 studies were included in the review. Studies on EVLP have found an association between platelet activation and adverse effects on lung function, whereas in lung transplantation, platelet activation appears to play a role in primary graft dysfunction. In both settings, the inhibition of platelets ameliorated these effects. Conclusions. Platelet activation in EVLP and lung transplantation results in distal arterial thrombosis and has been associated with graft dysfunction. The use of antiplatelet agents in the included studies was associated with reduced lung injury and improved lung function on EVLP or during lung transplantation.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001855 |
| spellingShingle | Ryaan EL-Andari, MD Jimmy J.H. Kang, MD Nicholas M. Fialka, MD Jason Weatherald, MD Parnian Alavi, MSc Nadia Jahroudi, PhD Darren H. Freed, MD, PhD Jayan Nagendran, MD, PhD Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review Transplantation Direct |
| title | Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review |
| title_full | Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review |
| title_fullStr | Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review |
| title_full_unstemmed | Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review |
| title_short | Platelet Activation on Lung Function During Ex Vivo Lung Perfusion, Lung Transplantation, and the Role of Antiplatelet Therapy: A Narrative Review |
| title_sort | platelet activation on lung function during ex vivo lung perfusion lung transplantation and the role of antiplatelet therapy a narrative review |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001855 |
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